CQC report explained · a residential care home
What the CQC found at Old Raven House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with risk assessments for falls, pressure sores, malnutrition, dehydration and medical conditions. Fire safety actions were not all complete, but interim measures included more staff and stopping use of an upstairs bedroom.
- Effective?
- Good
- People received assessments, trained staff support, food and drink suited to their needs, medicines support and access to healthcare. Staff used a health monitoring tool to identify when people were becoming unwell.
- Caring?
- Good
- People were treated with dignity and respect and were involved in decisions about their care. Staff supported people's choices, independence, privacy and preferred routines.
- Responsive?
- Good
- Care plans reflected people's needs and preferences and were updated when needs changed. People had activities, communication support and end of life plans tailored to their wishes.
- Well-led?
- Good
- Inspectors found a clear management structure, a visible registered manager and systems for audits, feedback and learning from incidents. Leadership and quality monitoring had improved since the previous inspection.
What inspectors found, January 2020
Rated Good; inspectors found kind, personalised care and improvements since the previous inspection, but fire safety work was not yet complete.
This was an unannounced inspection on 30 December 2019 and 3 January 2020. One inspector spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment, incident and quality records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were happy with their care. Inspectors found enough staff, suitable training, clean surroundings, safe medicines systems and personalised support.
The rating improved from Requires Improvement at the previous inspection, published in December 2018. The report links this to a change in ownership, management and quality monitoring systems. Some decoration needed updating, and fire safety actions from an external enforcement notice were still incomplete, although interim measures were in place.
Kind and respectful care
People described a homely and sociable atmosphere. Inspectors saw staff being patient, considerate and supportive of people's dignity and independence.
“People were relaxed and unhurried throughout their daily life.” from the report
Personalised support
Staff supported people's preferred routines, food choices, communication needs and activities. Care plans were being rewritten to include more personalised detail.
“People were supported to follow daily routines they were comfortable with.” from the report
Improved risk management
The home had strengthened how it assessed and monitored risks, including pressure sores and signs of deteriorating health.
“Since our last inspection, the provider had made improvements to their system for the identifying, reporting and monitoring of people at risk of developing pressure sores.” from the report
Good leadership and oversight
The registered manager was involved in daily care, and the home had regular audits, staff meetings and external management support.
“The registered manager had a good understanding of people's needs and made themselves available to assist people with their daily activities or personal care.” from the report
Activities and end of life care
People could take part in group or individual activities. The home had end of life care plans and had achieved accreditation in the Six Steps Programme.
“They organised a range of activities which included games, quizzes and exercises.” from the report
Fire safety actions outstanding
seriousThe provider had not completed all actions in a fire safety enforcement notice because of complications linked to the building's listed status. Interim arrangements were being used to reduce the risk.
“At the time of inspection, the provider was unable to complete all the actions listed on the notice, due to complications associated with the listed status of the building.” from the report
Some staff records incomplete
needs fixingSome older staff files did not contain all required recruitment information, including gaps in employment history. The manager was auditing files and obtaining the missing information.
“The registered manager was completing a full audit of staff files.” from the report
Worn decoration
minorSome parts of the home needed refreshing, including old carpet that was worn and stained. Replacement work was in progress.
“For example, the provider was in the process of replacing old carpet, which had become worn and stained.” from the report
- 01What actions from the Hampshire Fire and Rescue Service enforcement notice are still outstanding, and what is the timetable for completing them?
- 02How would my relative be evacuated in a fire, and how do the current interim measures affect people living upstairs?
- 03Have all staff files now been checked and completed, including employment histories and recruitment checks?
- 04Which parts of the home have had worn or stained decoration replaced, and what work remains?
- 05How will my relative's care plan be personalised, reviewed and updated if their needs or preferences change?
This was an unannounced planned inspection covering all five questions and the overall rating, with the previous Requires Improvement rating used to inform the inspection. This explanation was written from the published report of 21 January 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2018
Old Raven House was rated Requires Improvement overall; inspectors found kind, personalised care but safety and management systems were not yet reliably established.
Inspectors visited the home without notice on 15, 16 and 18 October 2018. They spoke with people, relatives, staff and health professionals. They observed care and checked records, medicines, staffing, training and management systems.
The inspection was triggered by concerns about pressure ulcers and how staff moved and repositioned one person. Inspectors found that training and guidance had improved practice. However, the home had not yet shown that these changes would continue consistently, especially without support from outside professionals.
People were protected from abuse, medicines were managed safely and there were enough staff according to the usual rotas. Inspectors also found good nutrition, healthcare support, dignity, activities and personalised care.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. This means the home was meeting many expected standards, but important safety and management improvements still needed to become reliable and lasting.
Kind and respectful care
Staff treated people with dignity, patience and compassion. They knew people's histories and preferences and supported independence.
“People experienced caring relationships with staff who treated them with kindness, respect and compassion.” from the report
Personalised support
Care plans reflected people's physical, emotional and social needs. Staff adapted activities and support to individual interests and communication needs.
“Care plans were person centred and fully reflected people's physical, emotional and social needs.” from the report
Improved mental capacity practice
The home had corrected problems found at the previous inspection. Staff followed processes for consent and best-interest decisions and protected people's rights.
“At this inspection we found that the required improvements had been made.” from the report
Medicines and recruitment
Staff were trained and checked for competence when giving medicines. Recruitment included references and Disclosure and Barring Service checks.
“Staff were trained to administer medicines safely and had their competency to do so checked every six months.” from the report
Good activities and relationships
People could follow hobbies and receive one-to-one support if they did not want group activities. Staff helped people keep important relationships.
“Where people chose not to participate in group activities the staff ensured they received individual one to one sessions to ensure they did not become socially isolated.” from the report
Earlier pressure ulcer concerns
seriousPeople's care had not always followed recognised guidance, and pressure ulcers had developed. The provider's systems had not identified the problem earlier.
“People's care, treatment and support had not always been delivered in line with best practice, based on recognised national guidance.” from the report
Staff under pressure
needs fixingStaff said that increasing complex needs left them stretched and reduced the quality time available to spend with people. A further staffing needs analysis was still being completed.
“Staff told us that the number of people needing support with more complex needs meant they were always stretched to the limit and had reduced the quality time they could spend with people.” from the report
Management checks missed risks
needs fixingThe provider's quality visits had not identified the concerns about pressure area management. New checks were being developed but needed to prove they worked without the registered manager.
“The provider had not replaced a deputy manager who had left the service in 2017 as they had hoped to develop team leaders into the role.” from the report
- 01What evidence can you show that pressure ulcer prevention and treatment remain safe and consistent now?
- 02How do you check that staff use the correct moving and repositioning techniques for each person?
- 03Has the further staffing needs analysis been completed, and what changes were made as a result?
- 04How do your quality checks identify pressure area risks and other clinical concerns before they cause harm?
- 05How will safe care and management oversight continue when the registered manager is absent?
This was an unannounced comprehensive inspection covering all five questions, prompted by concerns about pressure area management and moving and positioning; the previous inspection in August 2017 had rated the service Good overall. This explanation was written from the published report of 5 December 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Old Raven House
4 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.